The European Men-Who-Have-Sex-With-Men Internet Survey EMIS-2017 collected comparable data from 127.792 participants – men who have sex with men from 48 countries in Europe. It provides insights on their knowledge of HIV, viral hepatitis and sexually transmitted infections (STI), sexual behaviour, prevention needs and testing habits.
EMIS-2017 was executed by Sigma Research (London School of Hygiene and Tropical Medicine) as part of European Surveys and Training to Improve MSM Community Health (ESTICOM). It was a three-year project (2016-2019) funded by the European Commission Health Programme 2014-2020 through a tender by the Consumers, Health, Agriculture and Food Executive Agency (Chafea).
The results show considerable differences across the countries reflecting Europe’s diversity with respect to sexual health and behaviour of MSM. The report describes both MSM behaviour and needs, alongside resulting morbidities, and the likely value of current services to address these.
The Executive Summary indicates that sex between men remains the predominant mode of HIV transmission in the EU/EEA countries, where the first signs of a decline in reported new cases resulted from a 20% drop in new diagnoses among MSM (2015-2017). Responses to a survey that focused on knowledge about HIV and sexually transmitted infections, sexual behaviour, access to care, HIV-related stigma and the use of services for HIV and sexual health is a strong indication that this group cares about HIV and sexual health issues. For example, every second (56%) respondent had received an HIV test result in the last 12 months and almost half (46%) had tested for other STI during the same period.
On the occasion of the International Day Against Drug Abuse and Illicit Trafficking 26 June, the Global Commission on Drug Policy launched a report “Classification of Psychoactive Substances: When Science was Left Behind“. This GCDP ninth report analyses the history, procedures and inconsistencies of the current classification of psychoactive substances.
In the report, the Global Commission on Drug Policy explains how the biased historical classification of psychoactive substances has contributed to the “world drug problem”. It is the first-ever comprehensive report providing a political reading of the current evaluation and classification, or “scheduling” of drugs according to their harms. “The current distinction between legal and illegal substances is not unequivocally based on pharmacological research but in large part on historical and cultural precedents. It is also distorted by and feeds into morally charged perceptions about a presumed “good and evil” distinction between legal and illegal drugs.”
Psychoactive substances should be classified with regard to their potential for dependence and other harms. This is not the case today, where some substances are legally available because they are considered beneficial (medicines) or culturally important (alcohol), while others are seen as destructive, and are strictly prohibited. The classification of drugs is at the core of the international drug control system. As such, governments must ensure that such a classification is pragmatic and based on science and evidence, makes clear the benefits and harms of drugs, and allows for responsible legal regulatory models to control drugs.
Ruth Dreiffus, chair of the organization and a former president of Switzerland, wrote in the foreword: “…this classification or ‘scheduling’ of drugs is the cornerstone of the current repressive approach to drug policy, which has resulted in the ‘collateral damage’ of the ‘war on drugs—tragic consequences that the Global Commission on Drug Policy has condemned since its founding in 2011. The effects of prohibition—in terms of public health and security, discrimination and prison overcrowding, the rise in power of criminal organizations and the associated violence and corruption, as well as the lack of access to essential medicines—highlight the urgent need to change course and implement policies that are more effective and more respectful of human rights.”
On the occasion of the International Day Against Drug Abuse and Illicit Trafficking, the United Nations Office on Drugs and Crime (UNODC) presented the 2019 World Drug Report.
The World Drug Report 2019 is again presented in five separate parts that divide the wealth of information and analysis contained in the report into individual reader-friendly booklets in which drugs are grouped by their psychopharmacological effect for the first time in the report’s history.
Booklet 1 provides a summary of the four subsequent booklets by reviewing their key findings and highlighting policy implications based on their conclusions. Booklet 2 contains a global overview of the latest estimates of and trends in the supply, use and health consequences of drugs. Booklet 3 looks at recent trends in the market for depressants (including opioids, sedatives, tranquillizers and hypnotics), while Booklet 4 deals with recent trends in the market for stimulants (including cocaine, amphetamine-type stimulants and new psychoactive substances). Booklet 5 contains a review of recent trends in the market for cannabis and for hallucinogens. The section on cannabis also includes a review of the latest developments in the jurisdictions that have adopted measures allowing the non-medical use of cannabis.
As in previous years, the World Drug Report 2019 is aimed at improving the understanding of the world drug problem and contributing towards fostering greater international cooperation for countering its impact on health, governance and security.
In 2017, an estimated 271 million people, or 5,5 per cent of the global population aged 15-64, had used drugs in the previous year. Globally, some 35 million people are estimated to suffer from drug use disorders and who require treatment services (only one in 7 people who need support gets it). The Report also estimates the number of opioid users at 53 million, up 56 per cent from previous estimates, and that opioids are responsible for two thirds of the 585,000 people who died as a result of drug use in 2017. 11 million people injected drugs in 2017, of whom 1.4 million live with HIV and 5.6 million with hepatitis C.
“The findings of this year’s World Drug Report fill in and further complicate the global picture of drug challenges, underscoring the need for broader international cooperation to advance balanced and integrated health and criminal justice responses to supply and demand,” said Yury Fedotov, UNODC Executive Director.
Commenting the Report, Science for Democracy’s Coordinator Marco Perduca emphasized that “The theme of this year’s international day was “health for justice and justice for health”, though the disastrous impacts on the health of who is prosecuted, if not persecuted, for drug-related crimes is not acknowledged in the report. Much more is still invested in the securitarian and penitentiary aspect rather than the socio-sanitary one. All of this despite the increase in consumption and in particular problematic consumption. And yet, the Report ends with a recommendation about the necessity of providing help to those in need (only one in 7 people who need support gets it).”
New York based organisation Filter notes in their article that “the report failed to significantly evaluate widespread drug-associated human rights abuses—inherent to prohibition and accelerated by the ascendancy of far-right leaders“. There, Heather Haase, chair of the New York NGO Committee on Drugs, commented that “One thing that stood out in the report was, there was no section on human rights. That’s a huge issue in drug policy.”
The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) issued today their regular annual European Drug Report. The Report provides a comprehensive analysis of recent drug use and market trends across the European Union (EU), Norway and Turkey.
The 2019 report highlights in particular an increase in cocaine availability with seizures at a record high, amounting to 140.4 tonnes, double the quantity seized in 2016 (70.9 tonnes). Although the retail price of cocaine remained stable, its purity at street level reached its highest level in a decade in 2017.
The report notes the “Uberization” of the cocaine trade, where users and dealers use smartphones, messaging apps and satellite navigation to obtain the drug. Enterprising criminals have set up “cocaine call centres” across Europe to provide fast and flexible delivery services.
Heroin is still the most common illicit opioid on the drug market in Europe and is a major contributor to drug-related health and social costs. The quantity of heroin seized in the EU increased by over a tonne in 2017 to 5.4 tonnes, with an additional 17.4 tonnes seized by Turkey (some of which would have been destined for the EU market). Laboratories producing heroin from morphine using this precursor have been discovered in recent years in EU countries (Bulgaria, Czech Republic, Spain and the Netherlands). Heroin purity remains high and the retail price relatively low.
Belgium has overtaken Spain as the hub of the fast-growing European drug market. Belgium is playing an enlarged role in both the distribution and production markets of cocaine, methamphetamines and other illicit drugs, such as ketamine and GBL. The report also shows that Belgium, together with the Netherlands, is one of the main production centres for MDMA.
The Report also explores the challenges associated with new synthetic opioids, the latest developments in the cannabis market and synthetic drug production in Europe. Production of synthetic drugs appears to be ‘growing, diversifying an The purity of methamphetamine and amphetamine is higher than a decade ago, with 0.7 tonnes of methamphetamine and 6.4 tonnes of amphetamine seized in the EU in 2017. d becoming more innovative’ with methamphetamine posing the “greatest challenge”.
Legal recreational cannabis markets in some countries outside the EU were leading to “innovative” new products that presented difficulties for detection and control when entering the continent. The report points to fentanyl as a problem drug in Estonia, buprenorphine in Finland and the Czech Republic and methadone in Germany and Denmark. 11 new synthetic opioids were detected in 2018, including six new fentanyl derivatives. Since 2009, there have been 34 fentanyl derivatives detected in Europe, the EU agency says.
One in five people entering drug treatment facilities for an opioid-related problem “now reports a synthetic opioid, rather than heroin, as their main problem drug; and these drugs are becoming more commonly detected in drug overdose cases”. Around 8.200 people died of an overdose in Europe in 2018, according to the Report, around 300 more than in 2017. Most of the overdoses were not due to cocaine or other drugs, but rather opioids (heroin-induced), which made up 78% of all deaths. Researchers say the number of deaths could be 20% to 30% higher due to potential underreporting by member states. The spread of HIV has decreased by 40% over the past decade.
Providing people who inject heroin, or other drugs, with greater access to prevention, testing and treatment for HBV and HCV is central to combating viral hepatitis as a public health threat in line with the global 2030 Agenda for Sustainable Development, as they are the people with the highest burden of disease and at highest risk of transmission.
Mobile health applications are increasingly used in prevention, treatment and harm reduction.
Rather than focusing on illicit markets, flows of commodities or particular criminal groups, this report looks at places of interest: hotspots of organized crime in the Western Balkans. It looks at the characteristics of these hotspots, then provides a granular analysis of particular border crossings, intersections or regions of vulnerability. What makes these places particularly vulnerable? Why are they attractive to criminals? After discussing these questions, the report connects the dots between these locations to identify possible links and patterns that tell us more about the geography of crime in the region.
Regional illicit flows
To contextualize these organized-crime hotspots, the report provides an overview of the current situation in the Western Balkans, as well as some general information on the main illicit flows. It then looks at hotspots close to border or (internal) boundary crossings.
The other main section of the report focuses on major intersections of organized crime in the Western Balkans – mostly bigger cities (particularly capitals), coastal towns and places where major highways intersect. Maps are provided to show the hotspots as well as key traffic arteries. Amid these assessments, the report takes a deeper dive into vulnerable locations, such as Sarajevo, three ports along the Montenegrin coast, northern Kosovo as well as the triangular region where North Macedonia meets south Serbia and Kosovo.
One key observation of this report, which is important to highlight upfront, is that illicit flows through ports, cities and border crossings in the Western Balkans are enabled by a political economy of crime that is deeply entrenched in most countries of the region. The report therefore takes a look at the ecosystem of crime that creates an environment in which illicit activity can flourish. It concludes with a prognosis of potential future hotspots of crime.
Coalition prEUgovor published a new edition of their Alarm Report on Progress of Serbia in Chapters 23 and 24. This report contains the prEUgovor coalition’s assessment of the political criteria for the EU accession process and the fulfilment of criteria for selected policy areas from Chapters 23 and 24 for the period October 2018 – March 2019. The presentation was held on 16 April at the Media Centre in Belgrade.
The report states that the government continued the practice of abuse of public resources during the election periods, while the executive and the ruling majority continuously deprived the Parliament of its legitimate functions. Another worrying fact is the increasing number of laws that are being passed by urgent procedure and in most cases without any public debate. These practices have led to an alarming consequence – namely, the opposition has left the Parliament.
Besides the above, the authorities keep undermining the work of independent control institutions by systematically ignoring their recommendations. Once again, we have an atmosphere in which non-governmental organisations are declared enemies and traitors; they are left out of all the dialogues and are not welcome in the solving of social problems. At the same time, the government is creating its own NGOs (GONGOs).
The fight against corruption is at a very low level, threatening to become a mere simulation that is activated only periodically so that the authorities can easily score some cheap political points. Furthermore, there is a real danger that the very same mechanism (Law on Investigation of Property Origin) could be used against the opposition. Also, there are enormous problems with the potential consequences of the proposed constitutional amendments related to the judiciary, as well as a series of laws that are about to enter parliamentary procedure.
Generally speaking, the commitments made in the existing Action Plans for Chapters 23 and 24 are fulfilled inconsistently, while the deadlines are postponed on a regular basis. Well-known problems with the non-implementation of the existing acts and laws are still present. Having in mind the fact that two crucial EU issues to be addressed are the Rule of Law and the fight against corruption, lack of concrete results in these two areas is still a major alarming obstacle in Serbia’s process of integration.
The majority of the key findings expressed in this report coincide with the lowered ratings that were given to Serbia by various international actors (Freedom House, for instance), thus confirming the alarming developments in the areas covered by Chapters 23 and 24.
Coalition prEUgovor is a network of civil society organisations formed in order to monitor the implementation of policies relating to the accession negotiations between Serbia and the EU, with an emphasis on Chapters 23 and 24 of the Acquis. In doing so, the coalition aims to use the EU integration process to help accomplish substantial progress in the further democratisation of the Serbian society.
Members of the prEUgovor are: ASTRA – Anti Trafficking Action, Autonomous Women’s Center (AWC), Belgrade Centre for Security Policy (BCSP), Center for Investigative Journalism of Serbia (CINS), Center for Applied European Studies (CPES), Group 484 and Transparency Serbia (TS).
The National Public Health Organisation (Εθνικό Οργανισμό Δημόσιας Υγείας) publishes annually the HIV/AIDS Surveillance Report in Greece. This annual edition includes data that have been reported by 31 December 2018. Data were reported by Infectious Disease Units, Outpatients clinics for HIV infected patients, HIV/AIDS Reference and Control Centres and Hospitals.
In 2018, 687 new HIV cases were diagnosed and reported. Totally, 90 cases (13.1%), who were diagnosed with HIV in 2018, had already developed AIDS or progressed to AIDS during that year. Sex between men accounted for 40.0% of HIV diagnoses in 2018 followed by heterosexual transmissions (22.4%) and infections attributed to injecting drug use (15.4%). The predominant age group in both males (34.0%) and females (44.4%) was that of 30-39 years old.
The cumulative number of HIV diagnoses since the outbreak of the epidemics (including AIDS cases) reported in Greece by 31/12/2018 was 17,389. Of these, 14,397 (82.79%) were males and 2,951 (16.97%) were females. Sex was not reported for 41 (0.24%) HIV diagnoses.
Unprotected male-to-male sexual contact is the most frequently reported mode of HIV transmission in Greece. In total, 48.2% of HIV diagnoses, that were reported in Greece were Men who have Sex with Men (MSM) (table 9). After excluding cases with undocumented mode of HIV transmission, the aforementioned percentage comes up to 57.6%.
An outbreak of HIV occurred among PWID; 319 infections were diagnosed in 2011 and 525 in 2012. However, HIV diagnoses attributed to injecting drug use have been decreasing since 2013 and increasing by 2018 [2013 (n=270), 2014 (n=120), 2015 (n=95), 2016 (n=100), 2017 (n=93) and 2018 (n=106)].
Of 3,754 cases infected through heterosexual contact, the majority (53.3%) were females (tables 10, 11). After 2010, however, the percentage of males among heterosexually-infected cases increased (2015; males 54.7%), whilst in 2016 we notice the inverse pattern emerging women in higher levels (58.9%). Similar was the trend for 2017 and 2018.
AIDS case reporting started in Greece in 1984 while HIV case reporting started in 1998. Both are anonymous, confidential and mandatory by Ministerial Decisions.
The meeting of the partners in the EU Funded project “Strengthening NGO capacity and promoting public health and human rights oriented drug policy in South Eastern Europe” was held in Belgrade, Serbia, on Monday, 10 December 2018. This was the last meeting of the project which lasted for 4 years, supported by the European Commission DG Near.
The partners approved the minutes from the recent meeting, held on 12 September by Skype, and partners informed about the recent activities.
Margina has finished with the activities of the programme. Prevent has yet to implement a press conference, most probably in Belgrade by the end of the year. Diogenis has finished with the activities of the programme, except from the last newsletter. Olga Pateraki informed the partners of the reallocation regarding the budget of Diogenis, in order to translate in Greek and print the booklet “Drug Policy reform, The UNGASS 2016 a catalyst for change”.
DPNSEE Executive Director Milutin Milosevic informed the partners about the activities that has been implemented during this period: the country visits in Romania and in Greece, the General Assembly that took place in Belgrade, the capacity building that was held during September, the Resource Centre and the Glossary. The Glossary has been printed and there is in English, Spanish and Serbo-Croatian, with the intention to be translated also in other languages. The discrimination paper has been started but not reached yet the desired recorded cases.
The partners have agreed to send all their final financial reports by the 10th of January to Diogenis in order to prepare the final financial report, who is collecting and preparing the reports. The financial report will be also in a format of detailed breakdown that the EC asks along with the final report. The reports of the activities will be also sent to Diogenis in order to compile them for the final report in January.
With the support from the Central European Initiative (CEI) and funded through the European Union project, The Drug Policy Network South East Europe organised regular annual General Assembly on 10 December 2018 in The Palace of Serbia, in Belgrade, Serbia.
The participants at the Assembly were welcomed by Milan Pekić, Director of the Office for Combating Drugs of the Government of the Republic of Serbia. In their short opening speeches, Mr Pekić and the President of the Board of the Network Vlatko Dekov emphasized the importance of partnership in achieving the aim of effective drug policies.
The participants held voting rights from 16 out of 22 ordinary member organisations. That provided the Assembly with the right to make qualified decisions, even those related to the amendments to the Statute.
The Assembly was chaired by Anna Lyubenova, representative of the member organisation Initiative for Health Foundation from Bulgaria.
During the agenda point on membership issues, candidatures for membership from two organisations were discussed. The Assembly unanimously recognised as ordinary members Timok Youth Centerfrom Zaječar, Serbia and Center for Human Policy from Sofia, Bulgaria. The Network now has 24 ordinary and 2 associate member organisations.
The General Assembly discussed the Operational and financial report for 2018 and elements for the Action plan and the Financial plan for 2019. The General Assembly welcomed the reports. They will be completed with the activities in December and then be adopted. The Assembly analysed the donor and funding trends and issues and concluded that, based on donor research, negotiation and exchange, no funding from EU for the Network can be expected for 2019 and some amounts can be obtained for year 2020, more project based. Funding plans and activities and possible issues that might be funded in 2019 include budget advocacy, the Network being the leader on the issue of quality of services in the region, redefining harm reduction and human rights element of the approach in work. The need for greater participation in relevant international events and DPNSEE taking role in organizing regional events were emphasized.
Nine candidates applied for elections to the DPNSEE Board. The new Board includes Anna Lyubenova from Initiative for Health Foundation, Denis Dedajić from Margina, Marios Atzemis from Positive Voice, Nebojša Đurasović from Prevent, Safet Blakaj from Labyrinth, Sanja Šišović from Cazas and Vlatko Dekov from HOPS.
The Assembly decided to keep at the current positions Vlatko Dekov as the President, and Nebojša Đurasović as Vice-President.
An external consultant Jarmila Bujak Stanko facilitated the strategic workshop through which participants analysed achievement of aims and objectives of the strategic plan adopted in 2016 and indicated in which way and by which activities the priorities will be followed in the next two years.
The General Assembly ended in a positive and friendly atmosphere with an improved sense of belonging to the Network.
What is the evidence base for the medical use of cannabis and cannabinoids? What is the difference between cannabis preparations and medicinal products and why is this important? How is this issue regulated in the EU? These and other questions are explored in a new report published today by the EU drugs agency (EMCDDA): Medical use of cannabis and cannabinoids: questions and answers for policymaking. The report responds to growing interest in this topic as more European countries develop policies and practice in this area.
ʻMany EU countries now allow, or are considering allowing, the medical use of cannabis or cannabinoids in some formʼ, states the report. But approaches vary widely between countries, both in terms of the products permitted and the regulatory frameworks governing their provision. Understanding this variety of national approaches is important for an informed policy debate in this area in the EU.
The report aims to explore current practice in the EU regarding the provision of these substances for medical purposes and clarify some of the complex issues in this area in order to support science, policy and practice. The report notes that the terms ʻmedical use of cannabis and cannabinoidsʼ can refer to a wide variety of products and preparations that may contain different active ingredients and use different routes of administration.
The publication provides a state-of-the-art overview of evidence for the medical use of cannabis and cannabinoids. It concludes that more research and clinical studies are needed to fill ʻimportant gaps in the evidenceʼ.
The report highlights the challenges of decision-making in this area and summarises the multiple issues that governments may consider when deciding whether to make cannabis or cannabinoids available for medical use. These include: the types of product that patients will be allowed to use; the medical conditions for which such products can be used; and the type of medical and regulatory supervision under which patients are allowed to use them.
EMCDDA Director Alexis Goosdeel says: ‘In most countries, the provision of cannabis and cannabinoid products and preparations for medical purposes has evolved over time, often in response to patient demand or product development. This report seeks to provide an objective look at current evidence, practice and experience in this very fast-moving field and describe the complex patchwork of approaches adopted in the EU and beyond. Lastly, it points to the importance of developing a common language on this issue to help build a base for evaluation and assessmentʼ.